For people with a learning disability, focusing on individual needs provides more support than long-stay hospital care, writes Mark Goldring
Social care should be about people having a better quality of life and having choice and control over their lives. People with a learning disability must be able to choose whom they live with, where they live and what they do. This is what local authorities should be working towards and is certainly the vision set out by the government through Valuing People Now (the three-year strategy for people with learning disabilities announced earlier this year).
The closure of the last NHS long-stay hospital this week marks the end of the very opposite of this vision.
Many long-stay hospitals provided a truly disgraceful level of care for people with a learning disability. Too often people's basic human rights were abused and they were treated like lesser human beings. Being locked up, having no clothes of their own and sharing everything they did have with a large group of people are examples of the inhumane treatment some people with a learning disability have suffered in long-stay hospitals in the last century.
We only have to look to the appalling abuse and old-fashioned practices identified at Orchard Hill in January 2007 in a report by the Commission of Social Care Inspection (CSCI), to show that this type of segregated institutional living can breed contempt and complacency among staff. CSCI found that some residents were having only a few hours of activity a week, and the needs of individuals were being sacrificed for the needs of making the institution run smoothly.
That it has taken so long for Orchard Hill hospital in Sutton to close – despite a clear consensus that a hospital is not a suitable long-term home for anyone – highlights the lack of priority given to people with a learning disability in our society.
Orchard Hill missed the government's first deadline for closure of all long-stay hospitals in 2004 and a second in April 2006. This delay has left many people in limbo and uncertain of their futures.
Various excuses have been outlined. Sutton and Merton primary care trust, which runs the hospital, has blamed problems accessing funds to help pay for the closure of Orchard Hill. Legal challenges from parents against the initial decision to close the hospital have also been blamed. But the main reason for the huge delay is that the PCT failed to consult properly with residents and families, which has led to costly and unnecessary delays. Whoever is to blame, it is always people with a learning disability who suffer. Even now, after the long delay, the accommodation for the remaining 20 residents is not ready.
Instead of large, isolated institutions, people with a learning disability are now being supported in small community residential homes or in their own homes, with increasing personalisation and independence. But moving from a long-stay hospital can create challenges for individuals who have lived a life of isolation. It can be a frightening prospect when they face the outside world for the first time in decades and have to learn to live a completely new life.
When people with a learning disability move out of long-stay hospitals and into the community, it is vital they are given the right support to access housing, education, leisure and work.
The government must make sure that the needs of those going through this transition are met through proper person-centred planning that is genuinely based on individual needs, not the need to cut costs.
With the closure of the last NHS hospital behind us, people with a learning disability can look forward to a brighter future. This event marks a small but significant milestone.
However, there is still a long way to go until Mencap's vision and even the vision of Valuing People Now is fulfilled. The quality of care for many people with a learning disability must improve if people with a learning disability are to have real choice and control over their lives. This can only happen with proper investment in the social care system: an issue that will only get more acute at a time of cutbacks in public services.
• Mark Goldring is chief executive of learning disability charity Mencap
Joe Public Blog, 1st May 2009